Requesting reimbursement
Getting money from your FSA
There are two ways to be reimbursed for your qualified medical and dependent care expenses. One is "auto pay" automatic reimbursement, and the other is to fill out a reimbursement request form. Either way, the reimbursement check will be mailed directly to your home.
Using auto-pay automatic reimbursement
When your company's health expense
PriorityFSA
SM plan is set up, Priority Health will also turn on the auto-pay process. This means all claims submitted and processed through a Priority Health plan will also generate a check to you from your FSA to reimburse you for your copay or any other portion of the claim you paid yourself.
- Claims are paid automatically when you have Priority Health group medical coverage, group prescription coverage, or group dental coverage.
- When you complete the election form setting up your FSA, list all your dependents to be sure the system will recognize them and reimburse you for their expenses.
- You can call Customer Service and ask to have automatic reimbursement turned off.
Using an FSA withdrawal request form
You will have to send in a withdrawal request form when:
- You have insurance - medical, dental or vision - from another company as well as from Priority Health
- You have a PriorityVision plan
- You have a health savings account (HSA) and a limited FSA account
- You have dependent care claims
- You want to be reimbursed for medically necessary over-the-counter (non-prescription) drugs
- You have other qualified expenses not provided through Priority Health
Open the form, fill it out, print it, and submit it with your proof-of-purchase attachments and receipts to the fax number on the form:
Complete an FSA Withdrawal Request form (194KB PDF)
Complete a Limited FSA Withdrawal Request form (157KB PDF)
| Expense type | What you need to send in with the form |
|---|
| Medical |
Your Explanation of Benefits letter or final receipt from the doctor, hospital, or other health care provider
|
| Prescription |
The detailed pharmacy receipt (not the cash register receipt)
|
| Vision |
Your Explanation of Benefits letter or final receipt from the provider |
| Dependent care |
The name of the child who received the day care and a receipt showing the dates or date range of the services and the day care provider's name, address, and tax ID number
|
| Orthodontia |
Detailed invoice from the orthodontist showing what services your child is receiving
Note: Pre-payment expenses can be submitted only if the orthodontist requires pre-payment. Also, if the orthodontist accepts a payment plan such as monthly or quarterly payments, you must choose this option rather than asking for a lump sum from your FSA.
|
| Over-the-counter drugs |
Prescription from physician. This is not required to purchase the drug, but it is required to receive FSA reimbursement for the purchase. |
Processing times
Reimbursement usually takes 2-5 weeks, depending on the type of claim. Our speed depends on how quickly your doctor or dentist bills us for the services they provided to you. Priority Health processes FSA reimbursements on Sunday. We need to receive claim information or your reimbursement request form (complete with receipts or statements) by 7 p.m. on Thursday to process your FSA claim and issue you a check on Sunday.
Medical auto-pay claims and reimbursement request forms: 2-3 weeks
- Week 1-2: Funding requests are compiled and sent to your employer
- Weeks 2-3: Checks and Explanation of Benefits letters (EOBs) are printed and mailed
Prescription auto-pay claims: 4-5 weeks
- Week 1: We receive your claim from a pharmacy (3X a month)
- Weeks 2-3: We load your claim into our system as an FSA claim. This may take up to 10 days, because our pharmacy benefits system needs to validate the claim. A large number of pharmacy claims are reversed each month.
- Weeks 3-4: We compile funding requests and send them to your employer, and the FSA funds are pulled.
- Weeks 4-5: We print and mail checks and Explanation of Benefits letters (EOBs)
You'll need a recent version of Adobe® Reader software to view and print PDF files. Download it free now!
